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General NPI Number Information
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NPI Number | 1235075458
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Entity Type | Organization
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Legal Business Name | J RUSS SURGICAL ASSIST SERVICES LLC
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 2222 N NEVADA AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6819
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Country | US
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Telephone | 719-776-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 6045 PEMBERTON WAY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-2459
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Country | US
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Telephone | 303-503-8783
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Fax |
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Authorized Official
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Title or Position | RNFA
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Name | JENNIFER I RUSS
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Credential | RN
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Telephone | 303-503-8783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number |
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License Number State |
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